J Pediatr Infect Dis
DOI: 10.1055/s-0038-1648243
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Ralstonia insidiosa Neonatal Sepsis: A Case Report and Review of the Literature

Elçin Akduman Alaşehir
1  Department of Medical Microbiology, Maltepe University, Faculty of Medicine, Istanbul, Turkey
,
Belkız Öngen İpek
2  Department of Medical Biochemistry, Maltepe University, Faculty of Medicine, Istanbul, Turkey
,
David Terence Thomas
3  Department of Pediatric Surgery, Maltepe University, Faculty of Medicine, Istanbul, Turkey
,
Mustafa Erinç Sitar
2  Department of Medical Biochemistry, Maltepe University, Faculty of Medicine, Istanbul, Turkey
,
Tuğba Erener Ercan
4  Division of Neonatology, Department of Pediatrics, Maltepe University, Faculty of Medicine, Istanbul, Turkey
› Author Affiliations
Further Information

Publication History

08 November 2017

26 March 2018

Publication Date:
09 May 2018 (eFirst)

Abstract

IntroductionRalstonia spp. are nonfermenting gram-negative bacteria that have recently emerged as opportunistic pathogens. Previously, two case series of infection associated with Ralstonia insidiosa have been published. In this case report, R. insidiosa infection of a neonate in the neonatal intensive care unit (NICU) is presented.

Case Presentation A term male infant developed respiratory distress 2 hours after birth and was admitted to the NICU with the presumptive diagnosis of transient tachypnea of the newborn. A left apical pneumothorax was detected, requiring chest tube insertion. An umbilical catheter was placed due to poor peripheral vascular access. On the second day, blood cultures were sent from the umbilical artery and umbilical venous catheters, which showed growth of R. insidiosa. The antibiotics were changed from ampicillin and gentamicin to ampicillin–sulbactam and cefotaxime according to the antibiotic susceptibility test results. Respiratory distress symptoms resolved and the patient was extubated. The infant's clinical condition improved steadily and was discharged with breast feeding and stable vital findings, negative follow-up cultures, and C-reactive protein.

ConclusionR. insidiosa is an emerging pathogen in hospital infections due to its ability to survive in water supplies and sterilized water-based solutions. There is need for vigilance of R. insidiosa, especially in intensive care units. Awareness of rare pathogens, early detection of the bacteria, and antibiotic susceptibility test results are important in the success of treatment.